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Home|Press Centre|Photographs|Zanzibar: Nurses and midwives transforming the landscape of health

Fatma Hassan Saleh, Assistant In-Charge of the Children’s Department at Mnazi Mmoja Referral Hospital: “I know I can take care of a patient and then brief the doctor when he comes in. The old way of only receiving orders from doctors has changed. Now we consult over a case and then agree on a resolution like colleagues.”

AKDN / Christopher Wilton-Steer

Sultan Khamis Muki - learner, teacher, practitioner - joined the Aga Khan University’s Bachelors of Science programme in 2008: “I appreciate the intellectual capacity-building I received at AKU. I got a strong foundation, an understanding of research and the benefits of being rigorous and working hard.”

AKDN / Christopher Wilton-Steer

Hidaya Haji Shehe, nurse: “We were taught about scholarly writing at AKU, and I remember one of my colleagues one day presenting a case of a mother who had a premature baby. So now when I have an interesting clinical case I just write the entire patient history. One day it will be me presenting a difficult case.”

AKDN / Christopher Wilton-Steer

Jokha Omar Msuo, nurse: “I know I can’t juggle their schooling, working, and also focus on my own studies, so there has to be a sacrifice.” For now the choice is simple for this nurse and mother – “School will come later, for now I want to focus on helping the many mothers who need my help each day.”

AKDN / Christopher Wilton-Steer

Maryam Rashid Suleiman, Assistant Nursing Officer in Mnazi Mmoja Referral Hospital’s surgical ward: “There are no dirty patients in my ward. How can we be stitching wounds when we first have not helped a patient by getting them clean?”

AKDN / Christopher Wilton-Steer

Ramla Vuai Khamis, scrub nurse at Mnazi Mmoja – the largest and main referral hospital in Zanzibar: “The education I received gave me confidence to perform my role in new ways. Having the right knowledge and skills has given me courage.”

AKDN / Christopher Wilton-Steer

Wanu Bakari Khamis, teacher, matron, researcher - graduated with a nursing degree from Aga Khan University in 2008: “If we want to build this nation, it’s necessary that we give back however we can. That’s why I work with the government, with students, with NGOs and with clinics. Partnerships are so necessary if we want to have positive outcomes that impact thousands.”

AKDN / Christopher Wilton-Steer

Said Mussa Ali, senior health worker at the Primary Health Care Unit (PHCU): “We started sensitising people about the advantages of coming to deliver in the health facility, as well as the dangers of home delivery.” Said underwent his diploma training with Aga Khan University in 2012.

AKDN / Christopher Wilton-Steer

Sharif Haji Shehe works as the In-Charge at the Care and Treatment Centre (CTC), Kivunge Cottage Hospital. The bonds from his days as a student at AKU continue to thrive. “We were pioneers as students in distance education and many of us are keen to further our education after AKU. If we are asked to be pioneers of a new programme at masters level, we will be ready.”

AKDN / Christopher Wilton-Steer

Tatu Khamis Hussein is the In-Charge for an Oncology unit: “My motto is simple – we have to remember a few things to do this job the way we are supposed to: the rights of the patients, hygiene, safety and humility.”

AKDN / Christopher Wilton-Steer

Mohammed Ali Salim, Chief Nursing Officer for Wete Health Facility on Pemba Island: “They allow me in because I listen to them and I respect their way of living." At the time of his graduation in 2011, Mohammed was the second nurse to attain a degree in Pemba.

AKDN / Christopher Wilton-Steer

Rukia Rajab Bakar (centre) has developed research partnerships with various institutions, including some UN agencies. From her AKU experience, she knows how crucial research is to good practice and she is unabashed in ensuring these rigorous standards are upheld at the College of Health Sciences. “Sometimes I will turn away students who want to carry out research if their proposal is not up to standard. It’s important for students to understand how to excel, even if it’s through a hard lesson”.

AKDN / Christopher Wilton-Steer

Haji Nyonje Pandu (right) joined the AKU diploma programme in 2006, graduated in 2008, worked for a year, enrolled for the degree programme and graduated with a nursing degree in 2012. “Things have changed a lot from when I started. Some doctors would verbally abuse nurses thinking that we were not a professional cadre. But armed with our new skills, we are getting better recognition.”

AKDN / Christopher Wilton-Steer

Since his graduation in 2011 from the nursing diploma programme, Abdallah Hassan has worked concertedly at changing HIV and AIDS communication, control and service delivery on Pemba Island. Today, Abdallah is an Assistant Programme Manager with the Zanzibar AIDS Control Programme, an initiative of the Ministry of Health. “We sometimes learn from others, what they are doing, but sometimes we say no, we should implement according to our situation; let’s take care of our problems, but according to our culture.”

AKDN / Christopher Wilton-Steer

Philomena Lwoga, midwife, hospital secretary at Kivunge Cottage Hospital: “I have been here a long time so mothers will sometimes look for me at home when they have a problem, and I will attend to them or counsel them there. I am part of this community.” Philomena received her diploma from Aga Khan University in 2008 and proceeded to pursue a degree with the Open University.

AKDN / Christopher Wilton-Steer

Rukia Bhaloo Lada graduated with her nursing diploma in 2008: “As a midwife I really enjoy conducting ultrasounds because I can intervene early in any problems I see for my patient. It allows me to take action, and I think I offer more than a person who is only a sonographer."

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Zanzibaris are served by more than 200 health facilities providing primary, primary-plus, secondary and tertiary health care. Located in northern Unguja, Mnazi Mmoja Referral Hospital is the only tertiary-level institution that provides full referral facilities and comprehensive surgical care. Nursing resources are governed by the Zanzibar Nurses and Midwives Council, an independent body dedicated to the welfare of the members of the profession and to advancing nursing and midwifery as essential and professional services on the islands.

While strongly-networked, the health system still endeavours to provide tertiary-level care. Less than 10% of facilities currently offer emergency obstetric and neonatal care. Against this backdrop, the role that each individual plays in the delivery of healthcare becomes even more critical.

At the forefront of those delivering care are nurses and midwives. These are the individuals who engage with patients by their bedsides, provide a first port of call in the community, and advocate for changes to health standards and regulations in response to the needs they see each day.

For over 15 years the Aga Khan University School of Nursing and Midwifery has been working with these individuals, helping build the necessary skills for the nurses and midwives of Zanzibar to transform the landscape of health. These are their stories.